The plot finds Reacher once again in the Midwest, this time being thrust into an investigation involving the illegal opioid trade, the pharmaceutical companies that often turn a blind eye in the name of profits, and the people dependent on them.

After spending the night with a woman named Michelle Chang (from Make Me), Jack Reacher is traveling through Wisconsin when he happens to stop at a pawnshop selling an unusual item: a 2005 West Point class ring.

Unwilling to accept that such a priceless thing would be willingly sold, Reacher suspects it to be stolen and decides against leaving town.

Reacher beats up Jimmy's gang and learns that the ring originally belonged to a fence named Arthur Scorpio, who runs a laundromat in Rapid City, South Dakota.

In Rapid City, Reacher encounters two other people with an interest in Scorpio: Gloria Nakamura, a detective who has tried and failed for years to find incriminating evidence of Scorpio's criminal enterprise, and Terrence Bramall, a private investigator hired by Tiffany Jane Mackenzie, a woman searching for her missing twin sister Serena Rose Sanderson.

Fearing that her sister will die, Mackenzie formulates a plan to move Rose to her home in Illinois, where her addiction can be treated in secret.